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Flashcards in Other antidepressants Deck (16)
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1

Other antidepressants - 5 drugs

Bupropion
Mirtazapine
Trazodone
Vilazodone
Hypericin

2

Bupropion - MOA

Weak inhibitor of neuronal reuptake of DOP, NOR, SER at their transporters DAT, NET, SERT.
Noncompetative antagonist at nicotinic cholinergic receptors

3

Bupropion - indications

Adjunct therapy for smoking cessation

4

Bupropion - adverse effects

Agitation, insomnia, nausea, weight loss

5

Mirtazapine - MOA

Antidepressant and antianxiety effects. Blocks presynaptic alpha2-adrenergic autoreceptors and heteroreceptors, causing increased neuronal release of NE and SER respectively. Increases NE levels more than TCAs.
Potent antagonist of 5-HT2 and 5-HT3 receptors.

6

Mirtazapine - adverse effects

Agranulocytosis.
Significant elevation of hepatic enzyme levels

7

Trazodone - MOA

Selectively inhibits the neuronal reuptake of serotonin.
Antagonist at 5-HT2A receptors

8

Trazodone - adverse effects

Considerable sedation and orthostatic hypotension

9

Vilazodone - MOA

Selectively inhibits neuronal reuptake of serotonin. Also partial agonist of 5-HT1A receptors (accounting for anxiolytic effect). Enhancement of serotonergic activity in CNS

10

Tetracyclic antidepressant (TeCA)

Mirtazapine

11

Mood stabilizers - 3 drugs

Lithium
Carbamazepine
Valproate

12

Lithium - Indications

Manic phase of bipolar disorder

13

Lithium - MOA

Reduces both manic and depressive symptoms, but greater activity for manic phase. Suppresses the formation of second messengers involved in SER and NE neurotransmission. Reduces formation of IP3 by inhibiting myo-inositol-1-phosphatase. Interferes with formation of cAMP. Maximal response after days/weeks.

14

Lithium - adverse effects

Neurotoxicity, cardiac toxicity (dysrhythmias). Nausea and vomiting are the earliest signs of overdose.
At therapeutic dose: drowsiness, weight gain, fine hand tremor, polyuria. Hypothyroidism.

15

Lithium - interactions

Renal lithium clearance increases during pregnancy.
Sodium competes with lithium for tubular reabsorption increased excretion of lithium.
NSAIDs and diuretics increase serum levels.

16

Valproate - indications as mood stabilizer

Rapidly cycling of manic and depressive episodes & pts with coexisting substance abuse